Drug and Alcohol Abuse - The Dual-Diagnosis Myth
In English, that means people who supposedly suffer from both substance abuse and mental illness.
There are several problems with this including the obvious fact that every substance abuser displays symptoms of some disorder or another.
"Symptoms" are invariably produced when people are impaired for long periods of time, regardless of the impairment, and are much more apt to be situational than not.
Another problem is that attempting to treat two separate conditions at the same time is almost always ineffective.
Until the primary alcohol or drug involvement is abolished no one can tell what else is real or merely symptomatic, and whether or not there is any other condition in need of attention.
The other problem is that the use of these labels gives treatment providers yet another excuse for their horrific failure rates of 85% to 95% - rates they can once again blame on the client, as in "s/he didn't work his/her program," now adding "s/he was mentally ill, no wonder it didn't work," rather than fixing their own flawed models and methods.
It's not unusual to get calls from former clients or their families who have been misled by programs and who have spent years trying unnecessary medications to solve problems that would have evaporated without incident had the primary dependence been addressed.
It's important to remember that most treatment programs generally benefit more from failure than they do from success. Successful clients rarely return or refer, while failures stumble from one program to another. (I am not the only counselor to have been fired by a traditional Minnesota program for "unacceptably low relapse rates.")
Adding complications to recovery, or using methods that promote relapse, are all part of the revolving door to continuing profits.
It's good to remember what many of us have learned - most substance abusers will find their secondary symptoms reduced or extinguished when they have detoxed and refocused their lives into productive, healthy, and happier channels.
Motivation, social and vocational skills, exercise and a healthy diet, along with productive interests will result in the elimination of mental health concerns for the vast majority of former alcoholics and addicts.
Before you let someone convince you or a family member that a dual diagnosis or a co-occurring disorder exists, find an effective program that works without resorting to either the label or the excuse.
Look for programs that use multi-focused methods that address the physical, social, and therapeutic aspects of the problem without the imposition of negative and counter-productive labels, medications, and models.